Family Forum / Parenting / Twins / July 2004

barrettfarm@adelphia.net wrote:

I ended up firing the doctor who told me "All twins go to bed," and getting
someone who knew how to use the word IF. I was much happier (though I did in
fact end up on bedrest). My second doctor was a sweetheart, and when he gave me
advice I knew he had *thought* about whether it made sense in my situation,
rather than just handing out a one-size-fits-all diagnosis. I am sure my
increased peace of mind made it easier for me to go to term (though of course
much of that was pure luck).

I don't know of a triple stroller that's very well designed for a toddler and
two babies, and they tend to be very expensive and very bulky. I should think
it might work to put one baby in a sling or Baby Bjorn and the other two in the
stroller. But I had my singleton quite a while after my twins, so I am not a
guru on the subject.

--Helen

Do you have any conditions that would make bedrest necessary?  Is your
cervix shortening or starting to dilate?  Are you having serious blood
pressure problems?

I carried my twins to 36 1/2 weeks without bedrest as there were no
indications for it.  I ended up having a very rough birthing experience,
but bedrest would not have changed that one bit.  I did stop working by
my own choice at about 25 weeks.  Neither my OB or my perinatologist
ever even asked me if I was still working or not.

I realize that the plural of anecdote is not data, but I can name lots
and lots of twin mommies I know who never went on bedrest.  IMHO, this
"standard practice" needs to be examined a little closer.

Jen
twin boys - 11/26/03

I think this is hooey. Your doctor is not looking at YOU and seeing YOU.
Either you can fire him (I would) and find a doctor who sees YOU and not
some vague standard that isn't even evidence-based, or you keep him and lie
through your teeth and not do bedrest but tell him you are, or you do the
bedrest for no *medical* reason whatsoever, for up to 3 months. And having
done bedrest twice due to extreme cervical effacement (down to 4mm both
times (8 weeks, and 11 weeks, allowed to shower once every other day,
confined to bed otherwise) I really don't recommend this last if you don't
NEED to.  It's so hard on you, you can't even imagine, and I don't think
this doctor understands the emotional, physical, social and other impacts
this really has on the woman so sentenced.

Here are some questions you might ask, if you feel the need to continue with
this doctor:

1. When you say bedrest, what are your guidelines?
   a. How many hours a day would you expect me to stay in bed, and in what
position?
   b. How much walking would you consider acceptable?
   c. What about a daily bath or shower? Would I have to sit down on a
chair in the shower?
   d.Would I be able to get up to use the bathroom?
   e. Would I be able to get up to prepare quick meals or to do light
chores? Would I be able to sit up to eat my meals?
   f. Would I be able to go to work or work from home?
   g. Would driving be OK?
   h. How much and what kind of sexual activity would be OK?
   i. In light of the severely increased risk of blood clots in people
confined to bed, what activities would I be able to do to increase blood
circulation safely?
   j.What exercises could I safely do to minimize muscle loss?

2. Why do you feel *my* specific pregnancy warrants such a negative
disruption to my everyday life? What reasons do you have to believe *I* will
experience premature labor or birth?

3. Would you consider, as an alternative to your blanket policy, an
evidence-based approach to managing my pregnancy, involving monitoring for
symptoms of preterm labor, use of salivary estriol or fetal fibronectin
tests, periodic ultrasounds of the cervix or manual cervical exams to
measure cervical length - and then advise bedrest if the test results
indicate a risk of preterm delivery, if cervical shortening occurs beyond a
certain tolerance, such as 2.5cm, or if internal coning is visible on
ultrasound? If not, why not?

4. Would you please tell me your reasons for requiring bedrest for all twin
mothers, in light of this article from the University of Iowa Hospital
(print out: http://www.vh.org/adult/provider/obgyn/twinpregnancy/) and this
one from the ACOG website itself:
http://www.acog.org/from_home/publications/green_journal/wrapper.cfm?document=20
02/ong13732fla.htm?

(By the way, I'm going to make a wild guess that this doctor will also
insist on inducing at 37 or 38 weeks, because "all twins are induced then"
or even insists on delivering surgically "for your own good" or some such
nonsense, even if both twins are presenting head-down.  If this is the case,
please run or waddle as fast as you can to another doctor who gives a damn
about *you* as an individual who happens to be pregnant with twins.)

Actually, I expect him to turn red in the face, or maybe purple, swell up to
twice his normal size, and tell you to find another doctor if you dare to
ask questions like these. I mean how dare you question him?  But I could be
wrong. Some doctors are very cool. I had one. If I thought you lived nearby,
I'd recommend her to you. But there you go.

--angela

Hi Stacey!
Just wanted to let you know that I found out I was having twins at 24 weeks.
My doctor immediately had me off of work and resting.  It wasn't "standard"
practice but it was his standard practice to do so at 20 weeks.
I could pretty much do what I wanted during the day but no major lifting, no
long walking ...... that kind of stuff.  I was very upset at the beginning
but I have to say in hindsight I'm glad for the time I did have.  However, I
was fortunate enough that I didn't have to stay in bed on my back 24
hours/day like some women.  Our lives were'nt that inconvenienced except for
DH having to do groceries and housework.
We had a "just turned" 2 toddler also.  I could still get on the floor and
play
with him, read to him, color with him......everything but pick him up.
For me I finally figured out to just make the best of it.  Our first was
born with a
bronchial cleft and I just really wanted healthy babies and if that's what
it was gonna
take that's what was important.  However, this wasn't the reason he put me
on bed
rest, like I said this is "his" standard practice.  And I didn't have a
choice to "fire" my doctor and find another one as OB's are hard to get
around here and you have to go through a
family doctor referral.  He is considered one of the best in our area and is
actually head
of the city OB.  I just respected his request.
Good luck!!!
Let us know how it goes

Shell
Mom to Anthony (5), Josh & Michael (3)

I think this is ridiculous. For one, there isn't even much (if any)
clinical evidence that bedrest can help extend a pregnancy. A normal,
uncomplicated twin pregnancy shouldn't "require" any bedrest at all.
Standard practice at 24 weeks? I don't think so!

I was on bedrest for the majority of my pregnancy, but I had a
cerclage, a cervix that was already softening and shortening at 13
weeks, and a history of midterm loss. Even with the bedrest, I only
carried my girls to 26 weeks and I'm not convinced the bedrest had
anything to do with it -- it was just better for my peace of mind.

Personally, I'd get a new doctor. Congratulations and good luck!

--
Paula
Mom to Olivia and Cassie (b. 4/8/03 @ 26 weeks)
^Grace^ (b. 5/16/02 d. 5/17/02) and ^Adam^ (b/d. 5/17/02)

Hi Stacey,

I agree with the other ladies. The doctor should look at your own
situation and not assume that because you are having twins you are
handicap in a certain way.
I did have to take it easy in my pregnancy because of my back. Having
a weak back, the weight from the girls didnt help. With 4 months i had
to start working part time .. and with 6 months stop completely. But
the pregnancy itself was fine .. if it was up to the girls I would have
working until the end.
About the stroller ...  A friend of mine also has the Urban Jungle, to
which you can add a little seat in the front for the older kid. She has
twins and a 2 year old boys ...
I know it is a pretty expensive stroller, buggy but with a weak back
I had to get something easy to push.

Greetings and congratulations on your pregnancy...  Enjoy it!!

Mirethy
Mother to Kreychelle & Draychelle 12th may 2003

Whether to invest in a triplet stroller depends on how much you will use it.
If you like to get out of the house a lot, even in the winter, then it is
*definitely* a good investment, esp. if you get one used.  Watch the triplet
connection website's used stroller listings for a few weeks and you may find
someone local trying to get rid of one:  www.tripletconnection.org.

IMHO, the Runabout is the best triplet stroller by far ... and it
accommodates older kids / longer legs in the front seat better than any
other because it doesn't have a solid footboard, just "pedal" like foot bars
on each side of the front wheel.

It is also superior in weight, handling, cleanability, durability, value
....... don't get me started!  I still miss mine -- and we sold it over 3
years ago!

It handles upto 50# per seat and if possible you should get the basket
(definitely), a cup holder (any one from any store will fit), a sunshade for
your babies' first summer, but don't bother with the rainshield unless you
intend to walk in the rain a lot.

*If* you anticipate staying in your yard and not going too many places for
the twins' first year, a triplet stroller might be OTT, in which case I
personally like the front-back style twin strollers (e.g. Graco's one that
is around $130).  There is at least one Graco one that you can clip two car
seats to -- that sounds like a great idea to me.  And I have never seen the
Urban Jungle that another poster mentioned, but that sounds interesting.

--Janet
Elliot, Hanna, Connor  (10/21/96)
and Holly  (4/4/01)

Strange your doctor would say that.
my wife worked up until 2 days before she gave birth at 9 months +2 days.

No one always or nevers.

Sounds like you might need a triple stroller or just get one of those big
cribs with real wheels on them that I see being pushed around every now and
then.

Good luck and welcome!

Jack
Abigail and Jonathan 9-10-02